Yvonda R. Bradley

Phone: 770-***-**** Email: adygof@r.postjobfree.com

Leader/Analytical / Results Driven

Seasoned, Conscientious and Compassionate Business Office Supervisor/HR Professional with drive for helping employers recruit, develop and retain candidates. Skilled experience includes but not limited to; Microsoft Office, Citrix, Healthport, Soarian Financials, Cerner, NFuse, Souvera, Power Works, SSI, HMS, CredentialLink, Georgia MMIS, Epic, Relay, AS400, WayStar, Availity, E-Services, UHC, FACS, Direct Data Entry Palmetto GBA, ICD 9, ICD 10 and Electronic Medical Records.

Professional Experience

UHS OF SUMMITRIDGE HOSPITAL — LAWRENCEVILLE, GA 1/2020 – PRESENTLY

Business Office Supervisor

Monitors and reports on key metrics such as cash collections, days outstanding, unbilled, denials, etc., in conjunction with the CFO. Establishes, reconciles and maintains controls for all cash collected and posted in Patient Accounting system.

Mentor and coach A/R staff on department operating policies and procedures, establish and monitor quality and productivity standards while measuring performance and addressing improvement opportunities with staff.

Reviews all statistical reports to monitor trends, determine operational deficiencies, and implements corrective action plans as necessary.

Leads and provides operational directives for all Business office activities such as training employees to boost performance and enhance business results, monitors and evaluates personnel performance, complete annual reviews and make recommendation for promotions.

Maintains current working knowledge of medical billing and coding, HCPCS, CPT and ICD 10 codes, required modifiers, and encounter data. Working knowledge of Medicare, Medicaid and Managed Care insurances for inpatient and outpatient in the Critical Care Sector as well as Behavioral Health.

Evaluate daily workload and create work assignments for the team. Make recommendations to management on strategies for improving internal processes that maximize productivity and quality of work.

LAKEVIEW BEHAVIORAL HEALTH — NORCROSS, GA 4/2019 – 4/2023

Credentialing Specialist

Executed licensure and credentialing processes for new and existing providers including but not limited to obtaining or requesting required documentation from various third-party sources and regular communication with appropriate state board representatives and the Field Management Team.

Coordinated, conducted and documented required pre-delegation assessments and annual NCQA assessments as necessary to comply with applicable state, federal and accreditation requirements.

Identified, investigated, reported, tracked and followed-up on all potentially adverse information received from credentialing sources according to established guidelines, and forward to Risk Management and Medical Director for review.

Processed all practitioners under the terms and conditions of the entities’ agreement, including files credentialed through a Certified Verification Organization (CVO).

Yvonda R. Bradley

LAKEVIEW BEHAVIORAL HEALTH — NORCROSS, GA 4/2019 – 4/2020

Assistant Director/Business Office Manager

Managed daily office operations with a team of four professionals and served as point of contact for the Director of the Business Office. Recruited, hired, and trained all staff providing direct supervision, ongoing staff development and continuous education.

Meticulously tracked and resolved billing issues within the office resulting in the business office meeting their cash goal, ensured that the sub-ledger balanced for month end and decreased AR by 45% within 30 days of hire.

Posted charges, payments and adjustments to patient’s accounts in HMS. Applied payments, adjustments and denials into the medical manager system. Researched insurance denials and appeals and refiled appropriate paperwork.

EMORY DECATUR HOSPITAL — DECATUR, GA 12/2015 TO 4/2019

Medicare/Medicaid Billing Specialist

Collaborated with team members daily to successfully improve the efficiency of the billing process. Reduced receivable aging for assigned customers by 30% within 30 days of hire. Expedited the development procedures for clearing rejected claims and managed implementation of new contracts.

Investigated and resolved billing issues identified by insurance carriers and patients. Reviewed claim denials and payer requirements for corrective action and prevention in the future.

Completed daily billing for over 125 Medicare, Medicare Managed Care and Medicaid claims. Followed up and responded to all inquiries regarding the payers pertaining to eligibility, coordination/explanation of benefits and payments.

NATIONAL VISION INC — LAWRENCEVILLE, GA 6/2012 TO 12/2015

Billing Analyst II

Reviewed verified, obtained and corrected patient financial status and payor source information, medical diagnosis, laboratory and other diagnostic services information, hospital/clinic services and supplies, applicable dates, required authorizations and certifications, signatures, and other information related to preparation and processing of patient bills, and eligibility for coverage.

Reconciled accounts; posted payments; adjusted balances to reflect denials, adjustments, shares-of-cost, payments, and other modifications to balances; Prepared refund packages for approval.

Developed Quantity and Quality Access Database check system that reduced the error rate from 35% to less than 3%. Increased contract volume by processing 3,000 claims monthly.

Education

Denmark Technical College, Denmark, SC

Associates of Science in Industrial/Electronics Technology, 5/2004